Student Name: [ ] Adult or Age:
Address:
Phone Number(s): Email:
Chosen Instrument :
Preferred Style(s)/Genre(s):
Lesson Availability/Preference re: Frequency, Day & Time:
Request/Preference Re: Teacher?
Learning Style/Preferences/Interests/Goals:
[ Y/N ] request for instrument diagnosis?
[ Y/N ] interest in participating in All-Ages Student Showcase?
[ Y/N ] willingness to practice?
Comments/Details to share with Instructor
re: Background/Experience/Education
Theory:
Ear training:
Sight Reading:
Interval Training:
Performance:
Songwriting:
Extra Program Benefits
Student e-mails will be added to distribution list for advance notice of shows and events.
Free Magazines are available to students from the studio waiting area.
A 10% discount is offered on our merchandise.
Payment Policies:
- Tuition starts at $100 for a pre-paid series of 4 lessons with an automatic renewal
OR with a specific end date: _________________________ (attach receipt)
- On-going lesson payments will be arranged so as to be pre-paid at the start of each month, preferably by post dated cheques (payable to the office, att’d here) or signed credit card authorization*. Please complete the following section if you wish to arrange for pre-authorized payments by installment:
Please indicate your preferred payment option:
Monthly Payments ___ Full Term Payment ___
Signature:
Date:
Acknowledgement of Cancellation Policy:
As possible, we will accept or arrange “Lesson share partnerships” for students that wish to schedule lessons every other week, or other alternating timeframes.
Students must contact the office if they need to cancel a lesson. A cancelled lesson must have a minimum amount of 24hrs notice to qualify for a make-up lesson, which will be scheduled at teacher and student convenience, preferably within the same week.
If a student is unable to contact the office with 24hrs notice the lesson is considered a “no show” and the teacher is paid without any make-up lesson required. In exceptional cases make-up lessons might be arranged for the term’s end at the staff/teacher’s discretion.
Signature: Date: